CGM Coverage in Quebec
Does Quebec RAMQ provide Dexcom CGM coverage?
Yes, Dexcom G7 and Dexcom G6 coverage is available by the Régie de l’assurance maladie du Québec (RAMQ).
To receive coverage for Dexcom G7 or Dexcom G6 under RAMQ, you must meet the eligibility requirements for the Public Insurance Plan for self-monitoring of blood glucose in diabetic persons aged 2 years or over. Upon the initiation of treatment, the person:
- Under 18 years of age must have type 1 diabetes;
- Age 18 and over must be treated with intensive insulin therapy (treatment by insulin pumps or ≥ 3 insulin injections per day) and must meet one or more of the following criteria:
non-attainment of the value of glycated hemoglobin (HbA1c) adapted to the patient, despite optimal management of the disease; - frequent episodes of hypoglycemia in the last year, despite compliance with a glycemia management plan;
- inability to recognize or signal hypoglycemia symptoms.
Do I need a prescription to qualify for coverage?
Yes, you will need a valid prescription.
What do I need to get coverage approval?
The first step is to tell your physician or pharmacist that you’d like to receive a prescription for the Dexcom G7 or Dexcom G6 CGM System. The physician will then:
- Complete an Exceptional Medication Form and submit it to RAMQ for approval.
- Give you a prescription.
Once you have been approved, the pharmacy will process your order for Dexcom CGM supplies.
If RAMQ has already approved you for Dexcom G6 and you would like to start using Dexcom G7, ask your pharmacist to dispense G7 supplies.
How long am I approved for?
The initial request is authorized for a period of 6 months to assess patients' ability to use the Dexcom G7™ and wear the sensor.
The request for continuation of treatment is authorized if the person shows optimal use of Dexcom G7™, i.e., at least 70% of the time.
An annual clinical reassessment by the prescriber is recommended to ensure the person uses the sensor at least 70% of the time.
What if I have private insurance?
Private insurance plans must, at a minimum, cover medications covered by RAMQ. Most private plans now cover both Dexcom G76 and G6, even if you do not meet the RAMQ criteria. We suggest you contact your insurer for more details or speak with your pharmacist to verify your coverage.
Where can I get my Dexcom CGM supplies?
Dexcom G7 and G6 sensors must be purchased at your local pharmacy. Individuals without a compatible smart device are eligible for a free G7 or G6 Receiver and should contact Dexcom Customer Service at 1-844-832-1810 (Option 1).
Will I have any out-of-pocket costs?
For any remaining out-of-pocket costs, the Dexcom Savings program helps reduce or eliminate them, saving patients up to 20%. Download a copy of the program certificate below, which can be redeemed at the pharmacy with a valid Dexcom G7 prescription.
Secondary insurance plans may also work with your primary medical plan to help cover gaps in cost, services, or both. Check with your secondary insurer for details.
Do you have questions?
Our team is here to help! One of our Insurance Specialists can assist you in determining your Dexcom CGM coverage. Please get started by filling out our online form or calling us at 1-844-832-1810.
*Based on reasonable upcharge, mark-up and customary pharmacy dispensing fee.
† Best available information as of June 14, 2024. Subject to change.
† Best available information as of June 14, 2024. Subject to change.